CQC report explained · a nursing home
What the CQC found at Hillbro Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks, medicines, staffing and infection control were generally managed well, although some risk assessments did not fully explain how risks should be managed.
- Effective?
- Good
- This question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Caring?
- Outstanding
- This question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Responsive?
- Good
- This question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Well-led?
- Good
- Inspectors found effective checks on quality and safety, good communication and a management team that welcomed feedback. Some care plans still lacked enough detail.
What inspectors found, March 2023
Hillbro Nursing Home is rated Good; inspectors found safe care and strong management, with some care records needing more detail.
This was an unannounced inspection on 21 February 2023. Two inspectors and an Expert by Experience observed care, spoke with people, relatives and staff, and checked care, medicine, recruitment and management records.
The home was rated Good overall. Inspectors rated Safe and Well-led as Good. They found enough staff, safe medicines practice, suitable infection control and effective systems for investigating concerns and learning from incidents.
Some risk assessments and care plans did not fully explain how to meet people's needs. The provider had identified the care recording system needed improvement and sent information showing that some shortfalls found during the inspection had been addressed.
The previous rating was Requires Improvement, published in November 2020. Inspectors found enough improvement for the home to be no longer in breach of the regulations. The overall rating also used ratings from questions not inspected during this visit.
People felt safe
People, relatives and staff were confident that people were safe. Staff understood safeguarding procedures and concerns were referred and investigated appropriately.
“The service had effective systems in place to ensure allegations of abuse or poor care were investigated and acted on.” from the report
Safe staffing
Inspectors found enough competent staff to meet people's needs. The home had reviewed staffing and added an extra shift during a busy period.
“The service had enough competent staff for people to stay safe.” from the report
Medicines and infection control
Medicines were administered, recorded and stored safely. Inspectors were assured that infection prevention arrangements were effective.
“Medicines were administered safely. Staff followed effective systems when ordering, dispensing administering and recording medicines.” from the report
Strong management
The management team had good oversight of the home and used audits to check care, safety, staffing and the environment. People and staff said their views were listened to.
“Systems and processes for monitoring quality and safety were effective.” from the report
Positive relationships
Inspectors observed kind and responsive care. Relatives, staff and visiting professionals gave consistently positive feedback about the home.
“Our observations reflected people's feedback and we saw staff were caring and responsive to people's needs.” from the report
Some risk assessments lacked detail
needs fixingA few assessments did not clearly explain how important risks should be managed. One falls assessment did not show how to manage the risk effectively, although the provider responded to the findings.
“We saw several gaps where assessments did not robustly cover key areas of risk.” from the report
Care plans were not always detailed enough
needs fixingCare was usually planned and reviewed, but some plans did not fully explain how staff should meet people's needs. The provider planned to change the electronic recording system.
“Records showed people's care was usually planned and reviewed, although we saw examples where plans did not fully explain how to meet people's needs.” from the report
Staff wanted more time with people
minorStaff said staffing levels were enough for safety, but some wanted more time to spend with people and improve the quality of care.
“Two staff told us although there were enough staff, they would like to be able to spend more time with people to enhance the quality of care.” from the report
- 01How have you updated risk assessments, especially for falls, and how do you check that staff follow them?
- 02When will the new electronic care recording system be introduced, and how will you make sure records remain accurate during the change?
- 03How do you make sure each care plan explains exactly how staff should meet the person's needs?
- 04How do you review whether staff have enough time for activities and one-to-one contact, beyond meeting essential care needs?
- 05Which ratings were carried over from the previous inspection, and when will those areas next be fully reviewed?
This was a focused inspection of Safe and Well-led; the other ratings used for the overall rating carried over from the previous inspection. This explanation was written from the published report of 21 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2020
Rated Requires Improvement; inspectors found risks in moving and handling, safeguarding and oversight, although staff were experienced and caring.
This was an unannounced inspection following concerns about safeguarding. Inspectors visited on 29 September 2020 and continued inspection work until 13 October 2020. They spoke with people, relatives and staff, observed care, and checked care, medicine and management records.
The home was not always safe. Moving and handling plans did not give enough detail about the correct sling, and people did not have their own slings. Some safeguarding incidents were not reported to the local safeguarding authority or the CQC.
Inspectors found that medicines, recruitment, infection control and the home environment were managed well. People and relatives spoke positively about the staff, who were described as kind and experienced. Managers responded quickly and took immediate action after concerns were raised.
The overall rating fell from Good at the previous inspection to Requires Improvement. This inspection only examined Safe and Well-led. Ratings for the other areas were carried forward from the previous comprehensive inspection.
Kind and experienced staff
People and relatives gave consistently positive feedback. Inspectors found that people were cared for by an experienced and consistent staff team.
“The staff are first class; I think they do a good job.” from the report
Medicines management
Medicines were recorded electronically and staff who administered them were trained and checked for competence. Monthly medicine audits were completed.
“Medicines were managed safely. The provider operated an electronic medication record which recorded people’s medicines clearly.” from the report
Infection control
Inspectors were assured about the home's arrangements for preventing and managing infection, including testing, social distancing and admissions.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Open management
The management team was visible and approachable. Staff, people and relatives said communication and teamwork were good.
“The management team were visible and approachable. The registered manager maintained daily oversight of the home.” from the report
Moving and handling risks
seriousPlans did not say what size or type of sling people needed. Staff gave conflicting information, so people were at risk of discomfort, falls or harm.
“People's moving and handling plans were not detailed. There was no information to indicate what size or type of sling was required.” from the report
Safeguarding was not always reported
seriousSome incidents involving people at the home were not referred to safeguarding bodies. This meant there was no external monitoring or oversight.
“Some safeguarding incidents had not been reported to the local safeguarding authority or CQC.” from the report
Checks did not find every shortfall
needs fixingThe home had audits and checks, but they had not identified problems with safe moving and handling or the reporting of abuse quickly enough.
“However, shortfalls were identified in monitoring safe moving and handling for people and reporting allegations of abuse.” from the report
Required notifications were missed
seriousThe provider had not always told the CQC about significant events and allegations of abuse. Notifications were submitted after inspectors raised the issue.
“Notifications about some significant events had not been submitted to CQC.” from the report
- 01Do each person's current moving and handling plan state the exact size and type of sling required?
- 02Does each person now have an individual sling, and how are slings laundered to reduce infection risks?
- 03How are safeguarding incidents identified, recorded and reported to the local safeguarding authority and the CQC?
- 04What additional checks have been introduced since the inspection, and what have they found?
- 05How do you make sure staffing levels are reviewed systematically against people's needs?
This was a focused inspection of Safe and Well-led after specific concerns; the other key question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 27 November 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Hillbro Nursing Home
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- November 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- January 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2016
Registered with the Care Quality Commission on 6 December 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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